The American healthcare system is rated 37th in quality of care by the World Health organization, and its costs run twice as high as the 36 superior systems. We need to recognize and deal with the commercial and political issues that stand between the citizens and a world-class healthcare system.

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  Against universal medical care for Americans, there are essentially Five - enemies that is. 

  The First is the singularly prominent AMA, consisting of the doctors (actually far from all) who insist upon exorbitant incomes (six to seven figures, whether skilled or mediocre) and possessed of the notion that their perspectives in all socio-scientific arenas reign supreme over those from any other quarter of scholarship, profession or public interest.

  The Second are the allied interests: drug companies, the makers of medical supplies and equipment, the hospitals and treatment facilities, and the non-doctor medical professionals, who suspect that any public "interference" into medical costs and availability could also ultimately affect them, which is actually sound -- if avaricious -- reasoning.

  The Third are the insurance companies who add nothing to the actual provision of medical care but much to the cost thereof (perhaps 30 percent) and to the administrative hassle interposed between patients and their care, too often regardless of urgency or patient discomfort, and who endeavor to disguise their true motives with self-serving propaganda disguised as benign if not helpful advertising.

  The Fourth -- it gets worse as we go down the list -- are our elected politicians, selected one would assume to represent the best interests of their constituents and the nation.  But that assumption is not a sound one, for if it was we would already have a system comparable to that of the other industrialized nations of the world, which in fact we do not.  What we have is rated 37^th in quality of care by the World Health Organization, and our healthcare costs are twice as much as the healthcare in the 36 superior systems. And 50 million citizens have no medical coverage whatever. 

  What wretched sense of priorities does it take on the part of our "leaders" to mount a military budget in excess of the next dozen highest nations combined, while our healthcare compares unfavorably to 36 other nations, all of which are less prosperous than ours?  Well, the system of legalized bribery that we call "campaign contributions" has much to do with it.  For instance, the chairman of the Senate committee charged with the responsibility to craft proposals for healthcare legislation is the recipient of the largest donations from the medical industry in all of Congress. Is it little wonder that he called for no testimony from any single-payer advocates in his public sessions until subsequently pressured to do so, but planned to rely solely upon testimony favoring approaches which embraced private profiteering, and, not incidentally, funneled funds into his campaign larder?

  Finally, the Fifth enemy of our healthcare – and there cannot be a kinder way to describe this – is the sappy electorate that allows the first Four to run roughshod over their own best interests.  They are too often vulnerable to the industry propaganda and political distortions, e.g: "This would be Socialism!"  And one must ask if they are content that 36 other ("Yeah, what do they know?") countries have better healthcare at half the cost, or are they supremely ignorant of those facts?  Will they again vote for the same Congress folks who have misrepresented their best interests and the best interests of their children?  Only the Almighty knows, and perhaps He is scratching His head.

  What to do?  First, we need to get beyond the blatant propaganda of the American medical industry and its bought-and-paid-for political panderers.  Then we need to take a look at what those 36 countries who do healthcare better than we do at half the cost.  Most who have done this and who do not have a vested (i.e. profiteering) interest in the healthcare system are sold on the single-payer model.  It's a good bet that you'd like it too if you took the trouble to look into it. 

  Then only one thing remains, and that is to demand that our congressional representative supports the course of our choice, and to clearly advise that not to do so will result in the loss of his or her job in the next election, and mean it.

  We need to get better than 37^th place at twice the cost.  Single-payer can do that.  We cannot continue to afford a healthcare system designed to reward the membership of the AMA, big pharma, and the insurance industry, at the expense of the welfare of our citizens.  Single-payer is the citizens' system.  

Authors Bio:
Rafe Pilgrim, after "a life largely wasted on hard honest work," found himself a jungle of turkey oak, scrub pine and giant palmettos up a dirt road running east of Crystal River, Florida, which neither school busses nor the U.S. Postal Service dare to assay. Sharing a house of his own design with Spanky the cat, Darla a pit bull, and a foundling of mysterious breed named Alfalfa -- all collectively known as Our Gang -- he spends his time "productively: writing poetry, working for peace, and gazing at the sky."


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Central High School of Philadelphia, University of Maryland, Syracuse University, University of Maine, Ursinus College, Air Force Intelligence (Washington D.C., Germany), Ford Motor Company, Philco-Ford Corporation, Eighth Day Gallery, Phi Kappa Phi, Romey Everdell Award for Journalism,(1988), Hole in one (1998), and struggling to find America ever since 2000.